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Multicenter Study
. 2022 Apr:97:37-42.
doi: 10.1016/j.seizure.2022.03.007. Epub 2022 Mar 10.

Brivaracetam as add-on treatment in patients with post-stroke epilepsy: real-world data from the BRIVAracetam add-on First Italian netwoRk Study (BRIVAFIRST)

Simona Lattanzi  1 , Laura Canafoglia  2 , Maria Paola Canevini  3 , Sara Casciato  4 , Emanuele Cerulli Irelli  5 , Valentina Chiesa  6 , Filippo Dainese  7 , Giovanni De Maria  8 , Giuseppe Didato  9 , Giancarlo Di Gennaro  4 , Giovanni Falcicchio  10 , Martina Fanella  5 , Edoardo Ferlazzo  11 , Massimo Gangitano  12 , Angela La Neve  10 , Oriano Mecarelli  5 , Elisa Montalenti  13 , Alessandra Morano  5 , Federico Piazza  14 , Chiara Pizzanelli  15 , Patrizia Pulitano  5 , Federica Ranzato  16 , Eleonora Rosati  17 , Laura Tassi  18 , Carlo Di Bonaventura  5 ; BRIVAFIRST Group Membership
Collaborators, Affiliations
Free article
Multicenter Study

Brivaracetam as add-on treatment in patients with post-stroke epilepsy: real-world data from the BRIVAracetam add-on First Italian netwoRk Study (BRIVAFIRST)

Simona Lattanzi et al. Seizure. 2022 Apr.
Free article

Abstract

Objective: Post-stroke epilepsy (PSE) is one of the most common causes of acquired epilepsy and accounts for about 10-15% of all newly diagnosed epilepsy cases. However, evidence about the clinical profile of antiseizure medications in the PSE setting is currently limited. Brivaracetam (BRV) is a rationally developed compound characterized by high-affinity binding to synaptic vesicle protein 2A. The aim of this study was to assess the 12-month effectiveness and tolerability of adjunctive BRV in patients with PSE treated in a real-world setting.

Methods: This was a subgroup analysis of patients with PSE included in the BRIVAracetam add-on First Italian netwoRk Study (BRIVAFIRST). The BRIVAFIRST was a 12-month retrospective, multicentre study including adult patients prescribed adjunctive BRV. Effectiveness outcomes included the rates of seizure response (≥50% reduction in baseline seizure frequency), seizure-freedom, and treatment discontinuation. Safety and tolerability outcomes included the rate of treatment discontinuation due to adverse events (AEs) and the incidence of AEs.

Results: Patients with PSE included in the BRIVAFIRST were 75 and had a median age of 57 (interquartile range, 42-66) years. The median daily doses of BRV at 3, 6, and 12 months from starting treatment were 100 (100-150) mg, 125 (100-200) mg and 100 (100-200) mg, respectively. At 12 months, 32 (42.7%) patients had a reduction in their baseline seizure frequency by at least 50%, and the seizure freedom rates was 26/75 (34.7%). During the 1-year study period, 10 (13.3%) patients discontinued BRV. The reasons of treatment withdrawal were insufficient efficacy in 6 (8.0%) patients and poor tolerability in 4 (5.3%) patients. Adverse events were reported by 13 (20.3%) patients and were rated as mild in 84.6% and moderate in 15.4% of cases.

Significance: Adjunctive BRV was efficacious and generally well-tolerated when used in patients with PSE in clinical practice. Adjunctive BRV can be a suitable therapeutic option for patients with PSE.

Keywords: Antiseizure medication; Brivaracetam; Cerebrovascular diseases; Focal seizures; Stroke.

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